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Heart palpitations

Show Alternative Names
Heartbeat sensations
Irregular heartbeat
Palpitations
Heart pounding or racing

Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.

You may:

  • Have an unpleasant awareness of your own heartbeat
  • Feel like your heart skipped or stopped beats

The heart's rhythm may be normal or abnormal when you have palpitations.

What makes your heart beat? - Animation

The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers. The SA node (anatomical pacemaker) starts the sequence by causing the atrial muscles to contract. From there, the signal travels to the AV node, through the bundle of His, down the bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an electrocardiogram (EKG or ECG). Doctors use an EKG to monitor the cardiac conduction system's electrical activity in the heart.

Heart Palpitations Quiz

  • Which of these may be a symptom of heart palpitations?

    Correct Answer
    The correct answer is all of the above. You may have one or more of these symptoms.

  • Are palpitations dangerous?

    Correct Answer
    The correct answer is maybe. Most of the time, palpitations are not dangerous. Palpitations are only a symptom and not an illness or medical problem. However, heart palpitations can also be a sign of a serious heart problem. Talk to your doctor about your symptoms to be safe.

  • If you're experiencing frequent or severe heart palpitations, how soon should you seek help?

    Correct Answer
    The correct answer is immediately. Seek help right away if you are short of breath, have chest pain, feel dizzy, lightheaded, sweaty, or if you just don't feel well. You should also see your doctor if your pulse is beating very fast or feels irregular, or if you have fainted. Even if your palpitations aren't bothering you, make an appointment with your doctor for a check-up.

  • If you're having palpitations, does that mean you have a heart problem?

    Correct Answer
    The correct answer is maybe. Palpitations are a common symptom and are often not a sign of a heart problem. However, people with heart disease may be more likely to have problems that cause palpitations. Some of these heart problems include narrowed arteries in your heart (coronary artery disease), heart failure, abnormal heart valves, and abnormal heart rhythms (arrhythmia).

  • Which other medical problems may cause heart palpitations?

    Correct Answer
    The correct answer is all of these can cause palpitations. An overactive thyroid can cause heart palpitations. So can a low blood count (or anemia) -- the heart may need to beat faster or harder when you have anemia. Medicines used for asthma, many cough and cold medicines, and other medicines may cause palpitations. During pregnancy, your heart works harder to pump more blood.

  • Drinking too much caffeine may cause heart palpitations.

    Correct Answer
    The correct answer is true. Caffeine excites or stimulates the heart, causing it to beat faster and sometimes causing an extra beat.

  • What else may cause heart palpitations?

    Correct Answer
    The correct answer is all of the above. Many people under stress may notice skipped or extra beats. Some cough and cold medicines cause palpitations, as can drugs such as cocaine or amphetamines. Herbs and supplements can also cause changes in your body, including both minor and severe palpitations.

  • If you see a doctor for heart palpitations, will you need tests?

    Correct Answer
    The correct answer is maybe. Your doctor will talk to you and check your pulse, listen to your heart, and perhaps perform an electrocardiogram (ECG). He or she will ask how often you have palpitations, how long they last, and what other symptoms you have. Based on the results, you may need blood tests to check for anemia or thyroid problems. You may need a chest x-ray, echocardiogram, or need to wear a device for days or weeks that records your heart rate.

  • What can you do at home to prevent palpitations?

    Correct Answer
    The correct answer is all of the above. It's important to get checked by your doctor. The tips mentioned above are steps you can take to help prevent or reduce the amount of palpitations you have. Reducing stress can help a lot. Take some time off, try some activities that you enjoy, and learn how to relax. If stress is a special concern, you may want to get extra support.

Considerations

Normally the heart beats 60 to 100 times per minute. The rate may drop below 60 beats per minute in people who exercise routinely or take medicines that slow the heart.

If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A heart rate slower than 60 is called bradycardia. An occasional extra heartbeat out of rhythm is known as extrasystole.

Palpitations are not serious most of the time. Sensations representing an abnormal heart rhythm (arrhythmia) may be more serious.

Cardiac arrhythmia: Heart palpitations and other symptoms - Animation

A wide range of symptoms, including palpitations, dyspnea, syncope, fatigue, dizziness, chest pain, and lightheadedness can be produced by different types of cardiac arrhythmia.

The following conditions make you more likely to have an abnormal heart rhythm:

  • Known heart disease at the time the palpitations begin
  • Significant risk factors for heart disease
  • An abnormal heart valve
  • An electrolyte abnormality in your blood -- for example, a low potassium level

Causes

Heart palpitations can be due to:

  • Anxiety, stress, panic attack, or fear
  • Caffeine intake
  • Cocaine, methamphetamine or other stimulant drugs
  • Decongestant medications, such as phenylephrine or pseudoephedrine
  • Diet pills
  • Exercise
  • Fever
  • Nicotine intake

However, some palpitations are due to an abnormal heart rhythm, which may be caused by:

  • Heart disease
  • Abnormal heart valve, such as mitral valve prolapse
  • Abnormal blood level of potassium
  • Certain medicines, including those used to treat asthma, high blood pressure, or heart problems
  • Overactive thyroid
  • Low level of oxygen in your blood

Home Care

Things you can do to limit palpitations include:

  • Lower your intake of caffeine and nicotine. This will often reduce heart palpitations.
  • Learn to reduce stress and anxiety. This can help prevent palpitations and help you better manage them when they occur.
  • Try deep relaxation or breathing exercises.
  • Practice yoga, meditation, or tai chi.
  • Get regular exercise.
  • Do not smoke.

Once a serious cause has been ruled out by your provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.

When to Contact a Medical Professional

If you have never had heart palpitations before, see your provider.

Call 911 or the local emergency number if you have:

  • Loss of alertness (consciousness)
  • Chest pain
  • Shortness of breath
  • Unusual sweating
  • Dizziness or lightheadedness

Call your provider right away if:

  • You often feel extra heartbeats (more than 6 per minute or coming in groups of 3 or more).
  • You have heart disease or risk factors for heart disease, such as high cholesterol, diabetes, or high blood pressure.
  • You have new or different heart palpitations.
  • Your pulse is more than 100 beats per minute (without exercise, anxiety, or fever).
  • You have related symptoms, such as chest pain, shortness of breath, feeling faint, or loss of consciousness.

What to Expect at Your Office Visit

Your provider will examine you and ask questions about your medical history and symptoms.

You may be asked:

  • Do you feel skipped or stopped beats?
  • Does your heart rate feel slow or fast when you have the palpitations?
  • Do you feel a racing, pounding, or fluttering?
  • Is there a regular or irregular pattern to the unusual heartbeat sensations?
  • Did the palpitations begin or end suddenly?
  • When do the palpitations occur? In response to reminders of a traumatic event? When you are lying down and resting? When you change your body position? When you feel emotional?
  • Do you have any other symptoms?

An electrocardiogram may be done.

If you go to an emergency room, you will be connected to a heart monitor. However, most people with palpitations do not need to go to an emergency room for diagnosis and treatment.

If your provider finds you have an abnormal heart rhythm, other tests may be done. This may include:

Review Date: 4/10/2022

Reviewed By

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Fang JC, O'Gara PT. History and physical examination: an evidence-based approach. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 10.

Miller JM, Tomaselli GF, Zipes DP. Diagnosis of cardiac arrhythmias. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli, GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 35.

Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 56.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Cardiac arrhythmia: Heart palpitations and other symptoms - Animation

Arrhythmia can produce a wide range of symptoms including palpitations, sensations of skipped beats or rapid forceful beats, dyspnea, chest pain or discomfort, syncope, fatigue, dizziness, and lightheadedness. In bradycardia, the heart is unable to meet the body’s blood needs. This may cause fatigue, dizziness, syncope, lightheadedness, or cardiac arrest. In tachycardia, the ventricles’ ability to pump blood efficiently to the body is compromised. This may cause palpitations, dyspnea, chest pain, dizziness, lightheadedness, and syncope. In bradycardia, the heart is unable to meet the body’s blood needs. This may cause fatigue, dizziness, syncope, lightheadedness, or cardiac arrest. In tachycardia, the ventricles’ ability to pump blood efficiently to the body is compromised. This may cause palpitations, dyspnea, chest pain, dizziness, lightheadedness, and syncope.
 

What makes your heart beat? - Animation

Let’s take a closer look inside the heart. The yellow objects are not nerves. They’re actually specialized cardiac muscle cells in the walls of the heart. Their job is to send signals to the rest of the heart muscle and cause a contraction. Together, this group of cells is called the Cardiac conduction system.

The main components of the Cardiac conduction system are the SA node, AV node, Bundle of His, Bundle branches, and Purkinje fibers. Let’s follow a signal through the contraction process. The SA node starts the sequence by causing the atrial muscles to contract. That’s why doctors sometimes call it the anatomical pacemaker.

From there, the signal travels to the AV node, through the Bundle of His, down the Bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an Electrocardiogram, or EKG.

Doctors us an EKG as a way of seeing how well the Cardiac conduction system works. Any changes to the EKG can mean serious problems.

 

Cardiac arrhythmia: Heart palpitations and other symptoms - Animation

Arrhythmia can produce a wide range of symptoms including palpitations, sensations of skipped beats or rapid forceful beats, dyspnea, chest pain or discomfort, syncope, fatigue, dizziness, and lightheadedness. In bradycardia, the heart is unable to meet the body’s blood needs. This may cause fatigue, dizziness, syncope, lightheadedness, or cardiac arrest. In tachycardia, the ventricles’ ability to pump blood efficiently to the body is compromised. This may cause palpitations, dyspnea, chest pain, dizziness, lightheadedness, and syncope. In bradycardia, the heart is unable to meet the body’s blood needs. This may cause fatigue, dizziness, syncope, lightheadedness, or cardiac arrest. In tachycardia, the ventricles’ ability to pump blood efficiently to the body is compromised. This may cause palpitations, dyspnea, chest pain, dizziness, lightheadedness, and syncope.
 

What makes your heart beat? - Animation

Let’s take a closer look inside the heart. The yellow objects are not nerves. They’re actually specialized cardiac muscle cells in the walls of the heart. Their job is to send signals to the rest of the heart muscle and cause a contraction. Together, this group of cells is called the Cardiac conduction system.

The main components of the Cardiac conduction system are the SA node, AV node, Bundle of His, Bundle branches, and Purkinje fibers. Let’s follow a signal through the contraction process. The SA node starts the sequence by causing the atrial muscles to contract. That’s why doctors sometimes call it the anatomical pacemaker.

From there, the signal travels to the AV node, through the Bundle of His, down the Bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an Electrocardiogram, or EKG.

Doctors us an EKG as a way of seeing how well the Cardiac conduction system works. Any changes to the EKG can mean serious problems.

 
 
 
 

 

 
 
 
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